Does sertraline cause brain zaps? (1+ ways to prevent it)

In this article, we will discuss whether sertraline causes brain zaps. We will also discuss some research studies and what one should do if brain zaps occur.

Does sertraline cause brain zaps?

No, sertraline does not cause brain zaps. It is not one of the listed side effects associated with this antidepressant. However, brain zaps are quite commonly experienced during sertraline or any other SSRI withdrawal – meaning when you stop or discontinue taking the medication, you may experience brain zaps. 

The severity of these symptoms can vary from person to person and depends on various factors, like the overall duration of sertraline treatment and the way you have stopped the medication. So, make sure to discuss sertraline discontinuation with your provider before you decide to do so abruptly.

What does research suggest?

There is limited research on sertraline-induced brain zaps. However, research has linked brain zaps with antidepressant withdrawal, especially selective serotonin reuptake inhibitor (SSRI) withdrawal. (1)

One research study indicated that antidepressant withdrawal brain zaps are often ignored, yet they’re quite frequently reported (2). Paroxetine is the most commonly associated SSRI with it, but other members of this class also cause brain zaps upon discontinuation (2). 

One questionnaire related to the potential triggers of brain zaps showed that most commonly people experienced this after discontinuing an antidepressant (3). 

The severity of these symptoms varied, based on individual-specific factors – such as the overall duration of antidepressant treatment, whether it was discontinued properly or abruptly, and other factors were also discussed. The research studies focused on the side effects of sertraline do not show brain zaps as a potential side effect.

Why does sertraline withdrawal cause brain zaps?

Sertraline withdrawal can cause brain zaps because of how this antidepressant works. Sertraline primarily inhibits the reuptake of serotonin, a monoamine excitatory neurotransmitter, by blocking serotonin transporters (SERT). (4,5)

This change in serotonergic activity can make your brain dependent on the antidepressant. This effect can become more prominent when you take the medication for a long time. When you discontinue the antidepressant abruptly, your brain doesn’t accept this sudden change. 

This results in a chemical imbalance in your brain leading to brain zaps. Some people may also experience brain zaps even when they’re tapering off the antidepressant in the best possible way. 

Antidepressant discontinuation should be done gradually, and dose tapering is crucial if one wishes to stop the medication with the least possible adverse events. 

If your dose has been recently reduced and you experience brain zaps, please reach out to your provider. Your doctor will make your taper schedule even slower to help your body adjust to this change.

Can you prevent sertraline withdrawal symptoms?

As discussed earlier, sertraline withdrawal symptoms can be prevented by taking it slowly. If you take away the medication too quickly, the symptoms you’ll experience will become more pronounced. So, the best way to prevent these symptoms is to take it slow. 

Gradual tapering helps your body adjust to the decreased doses. The common symptoms associated with sertraline withdrawal include: (1)

  • Dizziness
  • Nausea
  • Fatigue
  • Irritability
  • Headache
  • Insomnia
  • Anxiety
  • Electric Shock Sensations
  • Vomiting
  • Visual Disturbances
  • Tremors
  • Confusion
  • Seizures

The best way to prevent these symptoms is to follow the taper schedule, which typically includes: (6)

Tapering StageApproximate Dose Reduction
Start of TaperingCurrent therapeutic dose
Tapering Phase 1Reduce by 25-50% of the initial dose
Tapering Phase 2Further reduce by 25-50% of the current dose
Final Tapering PhaseGradual reduction until complete cessation

What to do if you are experiencing brain zaps while taking sertraline?

If you’re experiencing brain zaps while taking sertraline, please reach out to your healthcare provider. Sertraline does not typically cause brain zaps as a side effect, and if it is causing it while you’re taking this antidepressant, it should be closely monitored. 

The most common cause of brain zaps is antidepressant withdrawal – especially related to SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs). However, severe anxiety may also cause brain zaps in some individuals. 

So, if you’re taking sertraline properly but still experiencing brain zaps, your doctor may check whether sertraline is helping your anxiety properly. Severe mental health symptoms may not get better with sertraline monotherapy. 

So, if sertraline is not sufficient for you, your doctor will adjust your treatment or switch you to another antidepressant. Make sure you do not make any changes to your prescription.

Preventing brain zaps during sertraline withdrawal

In my experience as a pharmacist, I have come across people who experienced brain zaps after discontinuing sertraline abruptly. Some chronic users may also experience brain zaps while tapering off an SSRI. 

These symptoms are common when discontinuing these medications and do get better with time as your body adjusts to this change. However, you should ensure safe antidepressant withdrawal and properly follow the taper schedule provided by your provider.

References 

  1. Haddad P. The SSRI discontinuation syndrome. J Psychopharmacol. 1998;12(3):305-13. doi: 10.1177/026988119801200311. PMID: 10958258. https://pubmed.ncbi.nlm.nih.gov/10958258/ 
  1. Papp A, Onton JA. Brain Zaps: An Underappreciated Symptom of Antidepressant Discontinuation. Prim Care Companion CNS Disord. 2018 Dec 20;20(6):18m02311. doi: 10.4088/PCC.18m02311. PMID: 30605268. https://pubmed.ncbi.nlm.nih.gov/30605268/ 
  1. Papp A, Onton JA. Triggers and Characteristics of Brain Zaps According to the Findings of an Internet Questionnaire. Prim Care Companion CNS Disord. 2022 Feb 10;24(1):21m02972. doi: 10.4088/PCC.21m02972. PMID: 35144325. https://pubmed.ncbi.nlm.nih.gov/35144325/ 
  1. Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689
  1. The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZOLOFT (sertraline hydrochloride) tablets, for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839s74s86s87_20990s35s44s45lbl.pdf
  1. Horowitz MA, Taylor D. Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry. 2019 Jun;6(6):538-546. doi: 10.1016/S2215-0366(19)30032-X. Epub 2019 Mar 5. PMID: 30850328. https://pubmed.ncbi.nlm.nih.gov/30850328/ 

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